Trombosis Venosa Cerebral Asociado a Infección por el Virus de la Inmunodeficiencia Humana (VIH)

Trombosis Venosa Central en HIV

Abstract

Thrombosis is the presence of a clot within a blood vessel. Infection with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) predispose to a prothrombotic state, usually peripheral venous thrombosis of the lower limbs. We present the case of a 29-year-old HIV-positive man with 467 cell / mm3 CD4 T lymphocytes, without antiretroviral treatment. Hospitalized for severe holocranial headache and ataxia. On neurological examination, he presented predominantly brachiocrural paraparesis and right hyperreflexia, in addition to ataxia. Laboratory tests report negative for tuberculosis, cryptococcosis, and toxoplasmosis. Contrast-enhanced computed tomography and magnetic resonance angiography show cerebral thrombosis of the left venous sinus. Is treated with heparin 60 mg subcutaneously every 12 hours. At 15 days, clinical improvement is evident and discharge was decided with warfarin 5 mg orally / day and antiretroviral therapy with abacavir, lamivudine, lopinavir and ritonavir. In the 30-day control, he presented bilateral tinnitus and hearing loss, improved ataxia, hyperreflexia persisted in the lower limbs, and uncoordinated horizontal-rotational movements lateralized to the left; RM shows traces of thrombi. This association of cerebral venous thrombosis and HIV is rare in the world literature and has not been reported in Ecuador.